| NPI | 1518575513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN GONZALEZ Licensed Optician 239-270-8170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-07-16 |